NCDC Guidelines for Disinfection of Quarantine Facilities and Standard Precautions
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In view of the COVID-19 pandemic. I have prepared a presentation for the Quarantine Facilities. This is in accordance to the Guidelines issued by the National Centre for Disease Control, India. Keep safe. All the Best
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NCDC Guidelines for Disinfection of Quarantine Facilities and Standard Precautions
- 1. NCDC Guidelines forNCDC Guidelines for Disinfection of Quarantine FacilityDisinfection of Quarantine Facility && Standard Precautions for Infection ControlStandard Precautions for Infection Control NCDC Guidelines forNCDC Guidelines for Disinfection of Quarantine FacilityDisinfection of Quarantine Facility && Standard Precautions for Infection ControlStandard Precautions for Infection Control 1
- 3. Area /Area / ItemsItems Item /Item / EquipmentEquipment ProcessProcess Method / ProcedureMethod / Procedure CLINICAL AREA General clinical areas Dust mops Mop (No broom will be used for sweeping) Detergent/ • Sweep with dust or damp mop to remove surface dust. Sweep under furniture to remove dust from corners. Gathered dust must be moved using a hearth brush & shovel • Sweep tool should be cleaned or replaced after use • Prepare cleaning solution with detergent, warm water • Use the three-bucket technique to mop floor, one 3 areas Floors (clinical areas) – daily mopping Detergent/ sanitizer, Hot Water, Sodium Hypochlorite, Three buckets (one with plain water and one with detergent solution; one bucket for sodium hypochlorite Sweeping Cleaning Daily mopping bucket with plain water & one with detergent solution • Mop the area with warm water & detergent solution • After mopping clean mop in plain water & squeeze • Repeat procedure for remaining area • Dry the area & Mop again using 1% Sodium Hypo. • In between mopping - change if solution or water is dirty • Mop the floor starting at far corner of the room & work towards the door • Clean articles between cleaning Note: Mopping should be done twice a day
- 4. Area /Area / ItemsItems Item /Item / EquipmentEquipment ProcessProcess Method / ProcedureMethod / Procedure Ceiling and Walls Sweeping tool Duster Bowl/ small bucket of soap solution Plain water Damp dusting • Damp dusting with a long handled tool for the walls and ceiling done with very little moisture, just enough to collect the dust. • Damp dusting should be done in straight lines that overlap one another. • Change the mop head/cover when soiled Note: Should be done once a week or after examining a suspect case 4 examining a suspect case Care of mop Hot water Detergent Sodium hypochlorite 1% • Clean with hot water and detergent solution, disinfect it with sodium hypochlorite and keep for drying upside down.
- 5. Area /Area / ItemsItems Item /Item / EquipmentEquipment ProcessProcess Method / ProcedureMethod / Procedure Doors and door knobs Damp cloth or Sponge squeeze mop Detergent Thorough washing • The doors are to be washed with a brush, using detergent and water once a week (on one defined day); gently apply cloth to soiled area, taking care not to remove paint, then wipe with warm water to remove excess Cleaning agent. • Door knobs and other frequently touched surfaces should be cleaned daily. Detergent / Sanitizer-Warm 5 Isolation room Sanitizer-Warm Water, Sodium Hypochlorite (1%) Three buckets (one with plain water and one with detergent solution); separate bucket for (1%) Sodium Hypochlorite Hot water Detergent (1%) Sodium hypochlorite • Before cleaning an isolation room, liaise with infection control team for details of any special requirements. Staff will be instructed on specific cleaning procedures required with reference to • Safety uniform to be worn • Chemicals or disinfectants to be used • Also, if bed screen and shower screen are to be cleaned or changed, refer cleaning in isolation rooms
- 6. Area /Area / ItemsItems Item /Item / EquipmentEquipment ProcessProcess Method / ProcedureMethod / Procedure Isolation room Detergent/ Sanitizer– warm water, (1%) Sodium Hypochlorite Three buckets (one with plain water and one with detergent Terminal cleaning • Before cleaning an isolation room, liaise with infection control team for details of any special requirements. Staff will be instructed on specific cleaning procedures required with reference • Safety uniform to be worn • Chemicals or disinfectants to be used • Also, if bed screen and shower screen 6 with detergent solution); separate bucket for (1%) Sodium Hypochlorite • Also, if bed screen and shower screen are to be cleaned or changed, refer cleaning in isolation rooms Stethos cope Alcohol-based rub/Spirit swab Cleaning • Should be cleaned with detergent and water. • Should be wiped with alcohol based rub / spirit swab before each patient contact
- 7. Area /Area / ItemsItems Item /Item / EquipmentEquipment ProcessProcess Method / ProcedureMethod / Procedure All clinical areas/ (1%) Sodium Hypochlorit e, Rag piece, Blood • Wear non-sterile gloves • For large spills, cover with absorbent paper/ rag piece • if any broken glass and sharps, using a pair of forceps and gloves, carefully retrieve. Use a large amount of folded absorbent paper to collect small glass splinters. Place the broken items into the puncture proof 7 areas/ Laborator ies/ Wherever spill care is required Rag piece, Absorbent paper, Unsterile gloves, Spill care kit, Mop, Hot water Blood and body fluid spill care the broken items into the puncture proof sharps container. • Cover the spill with 1% sodium hypochlorite for 10-20 minutes contact time • Clean up spill and discard into infectious waste bin, and mop area with soap and hot water • Clean the mop and mop area with 1% sodium hypochlorite • Wash mop with detergent and hot water and allow it to dry
- 8. Area /Area / ItemsItems Item /Item / EquipmentEquipment ProcessProcess Method / ProcedureMethod / Procedure BP cuffs and covers Detergent Hot water Washing • Cuffs should be wiped with alcohol based disinfectant and regular laundering is recommended for the cover. Thermo meter Detergent and water Alcohol rub Individual thermometer holder Cleaning • Should be stored dry in individual holder. • Clean with detergent and tepid water and wipe with alcohol rub in between patient use • Store in individual holder inverted • Preferably one thermometer for each patient 8 Injection and dressing trolley Detergent and water Duster Disinfectant (70% alcohol) Cleaning • To be cleaned daily with detergent and water • After each use should be wiped with disinfectant Refrigera tors Detergent and water Absorbent paper or clean cloth Cleaning (weekly) • Empty the fridge and store things appropriately • Defrost, decontaminate and clean with detergent • Dry it properly and replace the things • Weekly cleaning is recommended
- 9. Other Equipment Disinfection • Oxygen concentrators etc. should be cleaned with moist cloth • Oxygen hoods and air filters should be cleaned with detergent and running water • Radiant warmer, microscope, bassinet, weighing machine and backside of the infusion pump, syringe pump and monitor etc. can be cleaned with 2% Glutaraldehydecan be cleaned with 2% Glutaraldehyde • Feeding articles should be cleaned and brushed with detergent and then boiled for 20 minutes Instrument, Equipment Cleaning Protocol to be followed
- 10. Area /Area / ItemsItems Item /Item / EquipmentEquipment ProcessProcess Method / ProcedureMethod / Procedure LODGING AREA General cleaning Detergent, Warm water Mop, 2 Buckets, Clean Utility Daily mopping floors Thorough washing • Scrub floors with hot water and detergent with using minimal water. (Do not pour water) • Clean with plain water • Allow to dry • Sodium Hypochlorite 1% mopping can be done Note: Recommend general cleaning procedure 10 Utility Gloves, Hand-Mops washing Note: Recommend general cleaning procedure should be done twice a day Lockers, tables, cupboard, wardrobes benches, shelves and cots Damp duster Warm water Detergent Dry duster Damp dusting • Damp dust with warm water and detergent
- 11. Area /Area / ItemsItems Item /Item / EquipmentEquipment ProcessProcess Method / ProcedureMethod / Procedure Railings Detergent/ Sanitizer, hot water, 1% Sodium Hypo 3 Small Buckets / Big bowls, One with plain water One with Detergent Soln. Daily dusting • Damp dust with warm water and detergent followed by disinfection with hypochlorite 11 Detergent Soln. One for Sodium Hypochlorite Mirrors and Glass Warm water Detergent water / cleaning soln. Damp cloth Wiper Cleaning • Using warm water and a small quantity of detergent and using a damp cloth, wipe over the mirror and surround, then using a dry lint-free cloth, buff the mirror and glass to a clean dry finish.
- 12. Area /Area / ItemsItems Item /Item / EquipmentEquipment ProcessProcess Method / ProcedureMethod / Procedure Sluice room Stainless steel/ Any other sink Powder cleanser Detergent powder Wiper Cloth Cleaning • Sinks are to be cleaned with a powder cleanser • First wet the sink. Sprinkle little powder cleanser & work the surface with a cloth, include the plug hole • Do not use the powder cleanser on dry sink • After removing spillage and any stains, flush away with running water. Wipe the surface of the sink. 12 Pantry furniture Duster Dusting • Damp dust Telephone Warm water detergent solution Duster General cleaning • Damp dust with warm water and detergent • Paying special attention to the ear and mouth piece and dry it properly
- 13. Area /Area / ItemsItems Item /Item / EquipmeEquipme ntnt ProcessProcess Method / ProcedureMethod / Procedure Desks Damp Cloth Furniture polish Dusting • Wipe top sides and draw handles with a damp cloth Wooden desks should be cleaned with furniture polish and buffed to clear glows. Pen holder etc to be cleaned or dusted Pantry Furniture Duster Dusting • Damp dust Warm • Wipe down with warm water and detergent. 13 Telephone Warm water, Detergent Solution, Duster General Cleaning • Wipe down with warm water and detergent. Remove any marks under arms and seat. Check for damage to stoppers, if stopper require replacement, report to maintenance department Furniture and Fittings Warm water and Detergent, Rag piece Dusting • Using warm water and detergent, damp dust all furniture and fittings, including chairs, stools, beds, tables, cupboards, wardrobes, lockers, trolleys, benches, shelves and storage racks, waste/ bins, fire extinguishers, oxygen cylinders, televisions window sills and dry properly
- 14. Area /Area / ItemsItems Item /Item / EquipmentEquipment ProcessProcess Method / ProcedureMethod / Procedure Bed tables, bedside lockers Warm water & detergent Wiper Duster Cleaning • Wipe down over bed table. Wipe top & underneath base and stand, using warm water & detergent. Dry on completion. • Wipe down the bedside. Remove marks from fronts of draws and sides. Using warm water and detergent, wash the top to remove any sticky marks and dust. Light Damp • Light switches to be cleaned of dust, spots and 14 Light switches & over- bed Lights cloth (never wet) Detergent Warm water Cleaning • Light switches to be cleaned of dust, spots and finger marks. Clean with damp cloth (never wet) & detergent. • Over-bed lighting to be damp dusted. Clean with warm water and detergent. Curtains Soft Clothes Water Mild Soap Solution Cleaning • Clean with water and soap for curtains
- 15. Area /Area / ItemsItems Item /Item / EquipmentEquipment ProcessProcess Method / ProcedureMethod / Procedure White clothes 1% Sodium Hypochlorite Tap water Washing • Should be washed under running water and soaked in 1% sodium hypochlorite for 20 mins. Note: PPE should be worn while washing soiled linen Mattress and Tap water Washing • Mattress and pillows should be covered with a reusable mattress cover • It should be changed for each patient and when 15 and pillow covers Tap water Washing • It should be changed for each patient and when soiled sent to the laundry according to schedule Water Jars Vim Powder Soap &Water Cleaning • Recommended boiled water for drinking • Water jars should be scrubbed/ cleaned with soap and water and boiled water before filling with water
- 16. Area / ItemsArea / Items Agents /Agents / Toilet CleanerToilet Cleaner ProcedureProcedure CLEANING OF TOILETS Toilet pot / Commode 1% Sodium Hypochlorite Soap Powder / Long Handle Angular Brush • Inside of Toilet Pot / Commode • Scrub with recommended Agents & Long Handle Angular Brush • Outside: Clean with recommended Agents; use a Nylon Scrubber Lid / Commode Nylon Scrubber & Soap Powder • Wet and scrub with soap powder & Nylon Scrubber inside and outside 16 Soap Powder Toilet floor Soap powder, Scrubbing Brush • Scrub floor with Soap Powder & Scrubbing Brush • Wash with water • Use Sodium Hypochlorite 1% dilution Showers Area / Taps and Fittings Warm water Detergent powder, Nylon Scrubber • Scrub Floors/Tiles with Warm Water & Detergent • Wipe taps & Fittings with damp cloth &detergent • Carefully clean underside of taps and fittings • Taps should be dried after cleaning Soap dispensers Detergent and water • Daily dusting • Weekly cleaning with detergent & water and dried Note: Dry the Floors with a separate drying Mop
- 17. STANDARDSTANDARD PRECAUTIONS FOR INFECTION CONTROL IN HOSPITALS 17 Hand Hygiene Personal Protection Instrument Processing Environment Control Bio Medical Waste Management
- 18. WHO: 5 MOMENTS OF HAND HYGIENEWHO: 5 MOMENTS OF HAND HYGIENE 18
- 19. HAND HYGIENEHAND HYGIENE To avoid spread of infection in hospitals and community Two methods of Hand Cleaning: 1. Hand Rub - Use Alcohol based Hand Rub 2. Hand Wash - Use a good soap 19
- 20. RESPIRATORY HYGIENE AND COUGHRESPIRATORY HYGIENE AND COUGH ETIQUETTEETIQUETTE •• Use a disposable tissue or cover your face withUse a disposable tissue or cover your face with elbow while sneezing or coughingelbow while sneezing or coughing •• Throw the used disposable tissue in the YellowThrow the used disposable tissue in the Yellow covered Bincovered Bin •• Wash your hands with soap and water or alcoholWash your hands with soap and water or alcohol hand rub after coughing and sneezinghand rub after coughing and sneezing 20 hand rub after coughing and sneezinghand rub after coughing and sneezing •• To promote respiratory hygiene in the hospitalTo promote respiratory hygiene in the hospital availability of masks should be ensuredavailability of masks should be ensured •• Isolate patients having fever, cold and cough orIsolate patients having fever, cold and cough or other respiratory syndromeother respiratory syndrome
- 21. COVID-19 Personal Protective Equipment Face Mask Nose+Mouth Nose+Mouth Eyes+Nose+Mouth Eyes N95 Mask Face Shield Goggles 21 Gown Apron Gloves Head Cover Head +HairHandsBodyBody
- 22. Standard Protocol for Using PPEStandard Protocol for Using PPE • Throw PPE in the correct colour bin immediately after use • Discard immediately the PPE in case it gets torn off and damaged 22 off and damaged • Do not touch the face or any other surface after wearing the PPE • Right method for wearing and taking off the PPE should be followed
- 23. COVID-19 BIO MEDICAL WASTE SEGREGATION Categories Type of Bag Type of Waste Treatment / Disposal Yellow Non-Chlorinated Plastic, Autoclavable Bags • Dunned off PPE • PPE will spills • Gloves • Shoe Covers • Head Covers • Disposable Bed-sheets Incineration or Plasma Pyrolysis or Deep Burial Non-Chlorinated Plastic, Autoclavable Bags • Eye Protection Goggles • Recyclable Material like pens • Plastic Water Bottles Autoclaving / Microwaving / Hydroclaving and then sent for recycling. 23 Red Bags • Plastic Water Bottles used by Quarantined person sent for recycling. Not to be sent for landfills White Puncture-Leak proof container Sharp waste including metals Auto or Dry Heat Sterilisation followed by Shredding / Mutilation / Encapsulation Blue Puncture-Leak proof container Glassware / Tubelights / CFL Bulbs / LED used in Quarantine Facility
- 24. SCENARIO HAND HYGIENE GLOVES GOWN MEDICAL MASK EYE- WEAR Always before & after patient contact and after contaminated environment √ If direct contact with blood & body fluids, Minimize direct unprotected exposure to Blood and Body FluidsMinimize direct unprotected exposure to Blood and Body Fluids 24 blood & body fluids, secretions, excretions, mucous membranes, non-intact skin √ √ If there is risk of splashes onto the healthcare workers body √ √ √ If there is a risk of splashes onto the body and face √ √ √ √ √
- 25. Environment Cleaning, Disinfection and Bio Medical Waste ManagementEnvironment Cleaning, Disinfection and Bio Medical Waste Management • Follow the Hospital Cleaning Protocol • 3-Bucket system for floor cleaning should followed • Isolation Room, Critical Area ( LR, OT, SNCU, ICU to be cleaned (mopped) with Bacillocid (AgNO3 + H2O2 Solution) or Hypochlorite solution(1 or 2%) atleast 3 times a day • Mops & Bucket trolley used in Isolation and Critical Areas should be separately kept GENERAL PRINCIPLES / UNDERSTANDING 25 GENERAL PRINCIPLES / UNDERSTANDING • There are various micro organisms in the hospital environment but only few are infectious and harmful • Microbiological surfaces are known to be breeding grounds • Transfer of infection from environmental surfaces to patient is mainly through hands thus it is important to maintain hand hygiene • COVID-19 virus is understood to be alive for many hours / days • Suspected Infected Area or surface should be sanitized before being re-used/visited • Disinfectants / Sanitizers may be effectively used • Standard Cleaning Protocol should followed for cleaning the hospital premises
- 26. BE ALERT BE PREPARED TAKE PRECAUTIONS DO NOT PANIC SAVE YOURSELF AND SAVE OTHERS 26 SyedSyed Fareed UddinFareed Uddin External AssessorExternal Assessor-- NQASNQAS BHOPALBHOPAL--M. P.M. P.